Provider Demographics
NPI:1598821647
Name:BRITT, JOANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:BRITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1511
Mailing Address - Country:US
Mailing Address - Phone:516-841-8354
Mailing Address - Fax:
Practice Address - Street 1:41 FOREST AVE STE 6
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2121
Practice Address - Country:US
Practice Address - Phone:516-841-8354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041473-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01721264Medicaid
NY01721264Medicaid